经皮氧分压评估下肢动脉硬化闭塞症经皮血管腔内成形术疗效的研究

Percutaneous partial oxygen pressure in evaluating the efficacy of percutaneous transluminal angioplasty for lower extremity arteriosclerosis obliterans

目的通过比较下肢动脉硬化闭塞症(ASO)经皮血管腔内成形术(PTA)前后的经皮氧分压(TcPO_(2))、踝肱指数(ABI)、趾肱指数(TBI)的变化,评价TcPO_(2)在评估下肢ASO患者PTA疗效的临床价值。方法ASO患者101例,下肢ASO患肢111例,行PTA术后2~9 d复查TcPO_(2)、ABI及TBI。根据有无T2DM分为T2DM组(n=57)及单纯ASO组(ASO,n=44)。根据术前TcPO_(2)水平分为重度缺血组(n=38)、轻度度缺血组(n=37)及正常组(Con,n=36)。根据手术方式分为球囊扩张术组(n=56)、球囊扩张+支架植入术组(n=37)及支架植入术组(n=18)。比较3种检测方法的检测结果。结果重度及轻度缺血组术后TcPO_(2)、ABI、TBI高于术前(P<0.05)。球囊扩张术及支架术组术后TcPO_(2)、ABI、TBI高于术前(P<0.05),球囊扩张+支架植入术组术后ABI、TBI高于术前(P<0.05)。结论TcPO_(2)可作为评估下肢ASO行PTA疗效的临床指标之一。TcPO_(2)在评价微循环状态方面优于ABI、TBI。

ObjectiveTo identify the clinical value of percutaneous oxygen partial pressure(TcPO_(2))in evaluating the efficacy of percutaneous transluminal angioplasty(PTA)in lower extremity arteriosclerosis obliterans(ASO)patients by comparing the changes of TcPO_(2),ankle brachial index(ABI)and toe brachial index(TBI)before and after PTA.MethodsTcPO_(2),ABI and TBI of 111 patients with ASO were examined 2~9 days after PTA.According to the presence of type 2 diabetes mellitus(T2DM),they were divided into T2DM group(n=57)and ASO group(n=44).According to the level of TcPO_(2) before surgery,they were divided into severe ischemia group(n=38),mild ischemia group(n=37)and normal group(n=36).According to the surgical methods,they were divided into balloon dilation group(n=56),balloon dilation+stent implantation group(n=37)and stent implantation group(n=18).ResultsThe postoperative TcPO_(2)(mmHg),ABI and TBI in severe and mild ischemic groups were higher than before operation(P<0.05).TcPO_(2),ABI and TBI in balloon dilation and stenting group increased after operation(P<0.05).The postoperative ABI and TBI were higher in the balloon dilation+stent implantation group than before operation(P<0.05).ConclusionTcPO_(2)can be used as one of the clinical indicators to evaluate the efficacy of PTA in lower extremity ASO.TcPO_(2)is superior to ABI and TBI in evaluating microcirculation status.